Morphologic evaluation of ruptured and symptomatic abdominal aortic aneurysm by three-dimensional modeling

Area of Science:

• Medical Imaging and Diagnostics
• Cardiovascular Surgery
• Biomedical Engineering

Background:

• Abdominal aortic aneurysms (AAAs) pose a significant rupture risk.
• Current risk stratification relies on maximal diameter (Dmax) and gender, which have limitations.

Purpose of the Study:

• To identify novel geometric indices from computed tomography (CT) 3D models of AAAs associated with rupture risk.
• To evaluate the improvement in rupture prediction accuracy by incorporating these indices.

Main Methods:

• Retrospective case-control study of 63 ruptured/symptomatic AAAs and 94 asymptomatic AAAs.
• 3D CT models generated for calculation of 27 geometric indices.
• Logistic regression and ROC curve analysis compared models with and without geometric indices.

Main Results:

• Univariate analysis identified 16 geometric indices associated with AAA rupture.
• Multivariable analysis revealed higher bulge location and lower mean averaged area independently predicted rupture.
• The model incorporating these two indices improved AUC from 0.67 to 0.75 (P < .001).

Conclusions:

• Two geometric indices, bulge location and mean averaged area, are independently associated with AAA rupture.
• Adding these indices to Dmax and gender modestly enhances the accuracy of AAA rupture prediction models.